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Compulsory Psychiatric Treatment in the Community

II. a Controlled Study of Patients whom Psychiatrists would Recommend for Compulsory Treatment in the Community

Published online by Cambridge University Press:  02 January 2018

Tom Sensky*
Affiliation:
Department of Psychiatry, Charing Cross and Westminster Medical School
Timothy Hughes
Affiliation:
Department of Psychiatry, Charing Cross and Westminster Medical School
Steven Hirsch
Affiliation:
Department of Psychiatry, Charing Cross and Westminster Medical School
*
Department of Psychiatry, West Middlesex University Hospital, Isleworth, Middlesex TW7 6AF

Abstract

Several English consultant psychiatrists were asked to identify which patients currently under their care they would recommend for treatment with a community treatment order, if such a provision existed. The psychiatrists were asked to match each such ‘nominated’ patient for age, sex and diagnosis with one or two control patients, not considered to require compulsory treatment in the community. From specific data collected, it was found that: the two groups did not differ in their ‘lifetime’ histories of psychiatric admissions, substance misuse, criminal charges or dangerousness; 65–72% of the total sample had a history of serious dangerousness; but in the 12 months before nomination, the ‘nominated’ patients were significantly less likely than the controls to have complied with psychiatric treatment, and more likely to have defaulted from follow-up. The results indicate that a psychiatrist's decision to recommend a patient for treatment with a community treatment order will depend predominantly on specific criteria related to the patient's recent past.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 

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References

American Psychiatric Association (1987) Involuntary Commitment to Outpatient Treatment: Report of the Task Force on Involuntary Outpatient Commitment. Washington, DC: APA.Google Scholar
Bursten, B. (1986) Posthospital mandatory outpatient treatment. American Journal of Psychiatry, 143, 12551258.Google ScholarPubMed
Dedman, P. (1990) Community treatment orders in Victoria, Australia. Psychiatric Bulletin, 14, 462464.CrossRefGoogle Scholar
Department of Health and Social Security (1989) (Secretaries of Health, Social Security, Wales and Scotland). Caring for People: Community Care in the Next Decade and Beyond. London: HMSO (Cm 849).Google Scholar
Dyer, C. (1987) Compulsory treatment in the community for the mentally ill? British Medical Journal, 295, 991992.Google Scholar
Geller, J. L. (1986) Rights, wrongs and the dilemmas of coerced community treatment. American Journal of Psychiatry, 143, 12591264.Google Scholar
Gunn, J. (1984) Mental Health Act (1983): progress or vitiation? Journal of the Royal Society of Medicine, 77, 96.Google Scholar
Hiday, V. A. & Goodman, R. R. (1982) The least restrictive alternative to involuntary hospitalization, outpatient commitment: its use and effectiveness. Journal of Psychiatry and the Law, Spring, 8196.Google Scholar
Kastrup, M. (1987) Who become revolving door patients? Acta Psychiatrica Scandinavica, 76, 8088.Google Scholar
Mental Health Act Commission (1986) Compulsory Treatment in the Community: a Discussion Paper. London: Mental Health Act Commission.Google Scholar
Miller, R. D. (1981) Confidentiality or communication in the treatment of the mentally ill. Bulletin of the American Academy of Psychiatry and Law, 9, 5459.Google Scholar
Miller, R. D. (1985) Commitment to outpatient treatment: a national survey. Hospital and Community Psychiatry, 36, 265267.Google Scholar
Mind (1987) MIND Policy Paper: Compulsory Treatment in the Community. London: National Association for Mental Health.Google Scholar
Monahan, J. & Shah, S. A. (1989) Dangerousness and commitment of the mentally disordered in the United States. Schizophrenia Bulletin, 15, 541553.Google Scholar
v. Gardner, R. Judgement of Mr Justice McCullough in the High Court of Justice, Queen's Bench Division. Royal Courts of Justice, 20 December 1985.Google Scholar
v. Hallstrom, R. Judgement of Mr Justice McCullough in the High Court of Justice, Queen's Bench Division. Royal Courts of Justice, 20 December 1985.Google Scholar
Rachlin, S., Pam, A. & Milton, J. (1975) Civil liberties versus involuntary hospitalization. American Journal of Psychiatry, 132, 189192.Google Scholar
Rohde, P. (1984) Compulsory treatment in the community: is it authorised under the Mental Health Act 1983? Bulletin of the Royal College of Psychiatrists, 8, 148151.Google Scholar
Rosenblatt, A. & Meyer, J. E. (1974) The recidivism of mental patients: a review of past studies. American Journal of Orthopsychiatry, 44, 697706.Google Scholar
Royal College of Nursing (undated) Community Treatment Orders. London: Royal College of Nursing of the United Kingdom.Google Scholar
Royal College of Psychiatrists (1987) Community Treatment Orders: a Discussion Document. London: Royal College of Psychiatrists.Google Scholar
Serban, G. & Thomas, A. (1974) Attitudes and behaviours of acute and chronic schizophrenic patients regarding ambulatory treatment. American Journal of Psychiatry, 131, 991995.CrossRefGoogle ScholarPubMed
Szmuckler, G. I., Bird, A. S. & Button, E. J. (1981) Compulsory admissions in a London borough. I. Social and clinical features and a follow-up. Psychological Medicine, 11, 617636.Google Scholar
Turner, T. (1988) Community care. British Journal of Psychiatry, 152, 13.CrossRefGoogle ScholarPubMed
Yudofsky, S. C., Silver, J. M., Jackson, W., et al (1986) The Overt Aggression Scale for objective rating of verbal and physical aggression. American Journal of Psychiatry, 143, 3539.Google Scholar
Zanni, G. & deVeau, L. (1986) Inpatient stays before and after outpatient commitment. Hospital and Community Psychiatry, 37, 941942.Google Scholar
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